Educational level, prevalence of hysterectomy, and age at amenorrhoea: a cross-sectional analysis of 9536 women from six population-based cohort studies in Germany

BMC Women's Health

Research Article

Karin Halina Greiser¹  Henry Völzke²  Klaus Berger³  Andreas Stang⁴  Alexander Kluttig⁵  Susanne Moebus⁶  Karl-Heinz Jöckel⁶  Doris Stöckl⁷  Christa Meisinger⁷ 

[1] Deutsches Krebsforschungszentrum (DKFZ), Abteilung Epidemiologie von Krebserkrankungen, Heidelberg, Germany;Institut für Community Medicine, Ernst-Moritz-Arndt-Universität, Greifswald, Germany;Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Germany;Institut für Klinische Epidemiologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Halle, Germany;Institut für Medizinische Epidemiologie, Biometrie und Informatik, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany;Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum der Universität Duisburg-Essen, Essen, Germany;Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany;

关键词: Hysterectomy;    Population surveillance;    Prevalence;    Education;    Amenorrhoea;   

DOI  :  10.1186/1472-6874-14-10

 received in 2013-10-11, accepted in 2014-01-09,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundHysterectomy prevalence has been shown to vary by education level. Hysterectomy influences age at amenorrhoea. The aim of this study was to examine these associations in Germany within population-based data sets.MethodsBaseline assessments in six population-based cohorts took place from 1997 through 2006 and included 9,548 women aged 20–84 years. All studies assessed hysterectomy history, school and professional degrees. Degrees were categorized into three levels each. Adjusted prevalence ratios and 95% confidence intervals (95% CI) were estimated.ResultsPrevalences were higher in West Germany than East Germany, increased by age, and leveled off starting at 55–64 years. The age- and study-adjusted prevalence ratio (lowest versus highest school level) was 2.61 (95% CI: 1.28-5.30), 1.48 (95% CI: 1.21-1.81), and 1.01 (95% CI: 0.80-1.28) for women aged 20–45, 45–64, and 65 and more years respectively. The estimated adjusted prevalence ratios per one unit decrement of the educational qualification score (range 1 = lowest, 8 = highest) were 1.29 (95% CI: 1.02-1.64), 1.08 (95% CI: 1.04-1.12), and 0.98 (95% CI: 0.93-1.03) for women aged 20–44, 45–64, and 65–84 years respectively. Age at amenorrhoea was on average 6.2 years lower (43.5 years versus 49.7 years) among women with a history of hysterectomy than those without.ConclusionsLower educational level was associated with a higher hysterectomy prevalence among women aged 20–64 years. Several mediators associated with educational level and hysterectomy including women’s disease risk, women’s treatment preference, and women’s access to uterus-preserving treatment may explain this association. At population level, hysterectomy decreases the age of amenorrhoea on average by 6.2 years.

【 授权许可】

CC BY   
© Stang et al.; licensee BioMed Central Ltd. 2014